| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $44.58 | $44.58 | $44.58 | |
Aetna
| Professional | $44.58 | $44.58 | $44.58 | |
Cigna
| Facility | $135.54 | $135.54 | $135.54 | |
Medica
| Facility | $39.79 | $46.81 | $349.35 | |
Medica
| Professional | $37.72 | $56.39 | $614.40 | |
United
| Professional | $35.51 | $48.94 | $90.47 |